Ramírez Degollado J, De La Torre Bravo A, Barinagarrementería Aldatz R
Servicio de Endoscopía, Hospital General, Tlalpan, México, D.F.
Acta Gastroenterol Latinoam. 1986;16(3):207-12.
Among the emergency procedures in patients with upper gastrointestinal bleeding the endoscopy is the most accurate; it will establish the diagnosis in about 95% of the cases, before an adequate treatment can be prescribed. Several endoscopic techniques have been employed to control the bleeding and laser photocoagulation, which applies luminous energy, restrain the bleeding. Nd-Yag laser photocoagulation was used in a retrospective study of 217 patients with active upper gastrointestinal bleeding. In all of the cases the bleeding was controlled at the moment of the endoscopic procedure. In 29 patients the hemorrhage recurred, mostly due to diffuse lesions like gastritis duodenitis of esophageal varices and only 18 of these patients required emergency surgery. There were no complications with the procedure. According to these results the Nd-Yag laser photocoagulation is an effective procedure for control of the upper gastrointestinal bleeding. It avoids emergency surgery and, if surgery is required later, the patients will be in better conditions. Gastrointestinal Bleeding, emergency endoscopy, Nd-Yag Laser, photocoagulation.
在上消化道出血患者的急诊治疗中,内镜检查是最准确的;在能够开出适当治疗方案之前,它能在约95%的病例中确诊。已经采用了几种内镜技术来控制出血,激光光凝术通过应用光能来止血。对217例活动性上消化道出血患者进行了一项回顾性研究,使用了钕钇铝石榴石激光光凝术。在所有病例中,内镜检查时出血均得到控制。29例患者出血复发,主要是由于胃炎、十二指肠炎症或食管静脉曲张等弥漫性病变,其中只有18例患者需要急诊手术。该手术无并发症。根据这些结果,钕钇铝石榴石激光光凝术是控制上消化道出血的有效方法。它避免了急诊手术,并且如果以后需要手术,患者的状况会更好。上消化道出血、急诊内镜检查、钕钇铝石榴石激光、光凝术